Endoscopy and colonoscopy center

SIBO : What can I do?

Small Intestinal Bacterial Overgrowth (SIBO) is an increase in the number of bacteria found in the small intestine.

In this organ there are less than 1000 bacteria per milliliter but in the case of SIBO these become hundreds of thousands or millions. These bacteria migrate from the colon or large intestine to the small intestine.

The increased number of bacteria causes a state of inflammation, which disrupts the intestinal barrier (leaky gut) or interferes with the absorption of nutrients

It also favors immune reactions that cause allergies, increased sensitivity to food or autoimmune problems.

The most common symptoms are pain or distention in the abdomen, diarrhea, flatulence, excessive bowel sounds, belching, weight loss, indigestion or heaviness. Do these annoyances sound familiar to you?

Other non-digestive symptoms that are common can be dullness or mental exhaustion and fatigue.

When you have these discomforts and you do not have an explanation of what causes them, I advise you to find out if you have SIBO

SIBO what can I do?
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What can cause SIBO bacterial overgrowth?

There are three main causes that favor the appearance of SIBO:

Changes in the normal anatomy of the small intestine

Any intervention that touches or damages the small intestine can cause SIBO in the future. For example, if you have had a gastric bypass, peritonitis or have undergone radiotherapy

There may also be anatomical defects such as diverticula or strictures due to inflammation or tumors.

Abnormal movement of the small intestine

Diseases or conditions that slow down the movement of the small intestine will favor the proliferation of bacteria. It is like when the water stops flowing and puddles or swamps form and become contaminated.

Diabetes or hypothyroidism are very common problems that serve as examples. Also using opiate pain medications (morphine, hydrocodone) or just getting older.

SIBO is a leading cause of diarrhea and weight loss in older adults

Alteration of the defenses of the small intestine

When the things that normally protect the gut are disrupted, SIBO can occur.

For example, Gastric acid, bile, and juice from the pancreas kill bacterias in small bowel. If there is cirrhosis, pancreatic diseases or gastric acid is decreased by omeprazole, there is a greater risk of bad bacteria proliferating

Our defenses can also be altered if we are malnourished, eat poorly or are overweight

Diagnosis of SIBO Small Intestinal Bacterial Overgrowth

Duodenal fluid culture

It is considered the most important test (Gold Standard) for the diagnosis of this condition.

The test consists in that during an upper digestive endoscopy, through a special probe, the liquid that is normally in the duodenum is aspirated and this is sent for culture.

In this way, the amount of bacteria that exist is known and a sensitivity test can be taken to antibiotics.

Has the advantage that it is more precise, but it is invasive as it requires an endoscopy and, furthermore, not all laboratories analyze this sample. In practical terms, only in very few places is it done.

SIBO Bacterial Overgrowth Breath Test

In this exam, you take an envelope of lactulose dissolved in water and you are going to blow on a piece of equipment every 20 to 30 minutes for two to three hours.

When there are more bacteria than normal in the small intestine, they break down lactulose, increasing the amount of hydrogen gas which is expelled with the breath and that is why we can measure it in the breath.

The advantage of this test is that it is easy, non-invasive, and cheaper, but it has the disadvantage that it is less precise than culture.

What can I do if I have SIBO?

The first thing I advise you is to do the SIBO test if you were diagnosed with irritable bowel but do not improve with treatments 😦

It’s also a good idea to look for SIBO if you’re still sick and your tests don’t have a clear explanation of what’s happening to you.

If you already have the diagnosis of SIBO bacterial overgrowth, I advise you the following 👉 :

Discover and correct (as long as possible) the roots of the problem. Sometimes the background or studies you have are enough

In other cases, more examinations must be done, such as an examination of the small intestine by Capsule Endoscopy.

You will need to take antibiotics for two weeks. The objective of these is not to destroy the bacterial flora of the intestine but to eliminate excess bacteria. During the consultation I will advise you on the most appropriate one for you.

Analyze what you are doing with your diet. If you take care of yourself too much or restrict yourself too much and you are still sick, it is not a good idea to continue with this plan.

If you are on the other side, start by making adjustments to habits such as stopping eating junk or processed things 🍕 🍔 🌭

Another thing you can consider is a variant of the low FODMAPS diet. It is an option when you have relapsed from SIBO or if you do not want to take antibiotics.

If you want to know if you have SIBO bacterial overgrowth of the small intestine schedule your appointment for consultation or breath test.

Call us at 📲  3207571313 or write to us on WhatsApp


Mauricio González Hernández 

Your Gastroenterologist in Medellín


How is the preparation for Colonoscopy?

Preparation for Colonoscopy

Hello, I am Mauricio González, your Gastroenterologist and the one who will perform the total Colonoscopy. I am going to give you recommendations so that you can prepare well for the colonoscopy.

The purpose of the preparation is to remove all the fecal matter from the colon so that it is clean and can be examined properly. In addition, good preparation makes the procedure easier and reduces the risks.

Preparation for Colonoscopy

How is the preparation for Colonoscopy?

Buy a box of Travad Pik that comes with two sachets and a glass.

The day before the exam, fill the glass up to 150 ml, pour the contents of one sachet and mix it for two or three minutes until it is completely dissolved.

Take it at 7 at night. After this, drink at least 5 glasses of liquid (Water, clear juice in water, tea, aromatic, aguapanela, Clight, coffee, still soft drinks). Do it slowly and at your own pace

If your exam is between 7 and 9 in the morning, repeat the previous procedure with the second envelope and take it at 10 at night. Remember to drink at least 5 glasses of liquid afterwards (Slowly and calmly).

If the colonoscopy is after 9 in the morning, drink the second glass at 5 in the morning and drink 5 glasses of liquid between 5 and 7 in the morning.

The preparation does not taste bad, but you can help yourself by sucking on a candy, sandwich or panela. If you experience nausea or vomiting for a while and start taking it again very slowly and in small sips.

What can I eat before the Colonoscopy?

Three days before the exam, avoid eating foods that contain seeds (Granadilla, Pitaya, Watermelon 🍉, grapes 🍇).

The day before you can have breakfast and lunch as you normally do, but hopefully you will not consume grain foods such as beans, lentils, chickpeas, peas or corn.

At the end of the afternoon you can eat a light snack such as a sandwich or arepa with ham. 🥐

From then on, do not eat any more solid things, although you can drink all the liquids you want such as juices in water, aromatics, tea, coffee☕️, Gatorade, jelly 

Other recommendations for Colonoscopy preparation

8 hour fast for solid foods:

Avoid eating solid foods 8 hours before the exam so that you do not have the risk of food residues going into the bronchi (Bronchoaspiration).

Bring an adult companion:

Due to sedation you may see some reflexes or your ability to concentrate diminished. That is why it is necessary to come with a person who is in charge of taking you home.

Therefore, it is not a good idea to come on a motorcycle or drive a car because this increases the risk of an accident.

Take your medications before the exam:

Before the procedure you can take your medications with a sip of water. If you are diabetic and take insulin, schedule the Colonoscopy as early as possible and apply it after the exam to reduce the risk of hypoglycemia.

Notify us about your health status:

If you have a delicate health condition or have had bad experiences during your exam or sedation, tell us so we can give you the appropriate recommendations or take the necessary measures.

You are not going to feel anything and here we are going to take care of you

We are all a little afraid of a new exam or when we have had bad experiences in the past. But our idea is that you are asleep, safe and without discomfort. After the exam, tell us how it went 👍.

In case of any inconvenience with your preparation for Colonoscopy, contact us by WhatsApp or call us at 📲3207571313.

I also invite you to learn more about us at https://endoscopiaycolonoscopia.com/en/


Mauricio González Hernández

Your Gastroenterologist in Medellín

Mauricio González Hernández - Doctoralia.co